At least 40% of Medicare Advantage plans to offer pop health benefits

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Dive Brief:

At least 40% of Medicare Advantage plans will offer new types of supplemental benefits at no additional cost to beneficiaries in 2019, according to a new Avalere report.

More than one-third of MA plans will provide coverage for home and bathroom safety devices and modifications, 27% will offer over-the-counter benefits and 22% will give transportation benefits, Avalere said.

Also, one-third of MA plans will cover nicotine replacement therapy and about 10% will provide caregiver support services, such as counseling and training courses.

Dive Insight:

The Trump administration is bullish on MA. At the America's Health Insurance Plans annual Medicare conference last week, CMS Administrator Seema Verma cited MA as an example of a program that's popular with both payers and beneficiaries.

"The lesson here is a basic law of economics: Choice increases competition, and competition drives up value," she said at the event.

With that in mind, CMS will soon allow MA plans to offer new supplemental benefits, which is expected to boost population health efforts. Plans can provide the benefits "to diagnose, prevent or improve the effects of injuries or health conditions or reduce avoidable emergency department visits."

"Recent changes to the Medicare Advantage program are presenting plans with opportunities to meet the needs of beneficiaries with high-risk health conditions," Sean Creighton, a vice president at Avalere, said in a statement. "The trend of more Medicare Advantage plans covering more supplemental benefits to meet the needs of patients positions the program well for continued enrollment growth."

CMS expects 36% of Medicare beneficiaries will have an MA plan next year and that enrollment will increase by 11.5% in 2019 to 22.6 million people.

The MA market is relatively stable at the moment. CMS said MA premiums are expected to decrease by 6% on average in 2019. A new Kaiser Family Foundation report found that 14 new payers will enter the market next year. However, KFF said five insurers, which account for about 23,000 Medicare beneficiaries this year, are leaving the market.

KFF found that payers will offer 2,734 MA plans for individual enrollment in 2019. That's more than 400 additional plans than this year, with the largest growth in Florida. The average beneficiary will have a choice of 24 MA plans next year, which is an increase over the average of 21 this year. Special needs plans will increase from 630 this year to 717 next year, KFF said.

However, not all seniors will have access to MA plans. While six counties will offer more than 50 MA plans next year, 246 counties will provide two or fewer plan options, including 115 counties that won't have any.

Overall, KFF said 19% of beneficiaries will have a choice between 10 or more payers. On the other extreme, 7% of beneficiaries will have two or fewer options.